More than half of America's doctors have now adopted electronic health records (EHRs), and the number of doctors and hospitals using EHRs continues to increase dramatically according to data recently released by HHS. This growth can be traced to the 2009 American Reinvestment and Recovery Act, which provided for incentive payments under Medicare and Medicaid to doctors and hospitals that adopted and meaningfully used EHRs. Since then, EHR adoption has exploded and shows no sign of slowing down.

The statistics are impressive: in 2008, only 17 percent of eligible physicians and 9 percent of eligible hospitals had adopted EHRs; but in 2013 over 50 percent of eligible physicians and 80 percent of eligible hospitals have adopted EHRs -- more than double the number of physicians and hospitals that had adopted EHRs in 2012. According to HHS Secretary Kathleen Sebelius, the healthcare industry has reached a "tipping point" in the adoption of EHRs, which she says is "critical to modernizing our healthcare system" and can help providers "better coordinate care, which can improve patients' health and save money at the same time." Many industry groups, such as the Texas Medical Association (TMA), the Health Information and Management Systems Society (HIMSS), and the HIMSS Electronic Health Record Association (HIMSS EHR Association), seem to agree and have publicly expressed support for the EHR incentive payments.

But not everyone is happy with the EHR incentive program. On April 16, 2013, six Republican senators published a paper that sharply criticized the Obama administration's implementation of the EHR incentive program. The paper raised five key implementation deficiencies:

  1. The lack of a clear path toward interoperability;
  2. Concerns that health information technology (HIT) may increase costs and fail to control costs as previously estimated;
  3. A general lack of HIT program oversight;
  4. Privacy and security risks; and
  5. Concerns over whether providers can afford to maintain the EHR programs long term.

Along with the paper, the senators also issued a letter to HIT stakeholders requesting comments on the issues raised.

The TMA, the HIMSS and the HIMSS EHR Association all responded in support of the EHR incentive program. The TMA pointed out that in order for a clear path toward interoperability to materialize, providers first must have EHRs to interoperate with. The TMA also pointed to the dramatic impact the incentive payments have had on Texas providers -- the number of Texas physicians using EHRs has risen from 25 percent in 2005 to 60 percent in 2012, with another 22 percent planning to adopt EHRs in the next two years. The HIMSS and the HIMSS EHR Association echoed the TMA's interoperability arguments, adding that the program's Stage 1 meaningful use criteria established an important foundation for interoperability. But all three organizations recognized that difficult interoperability concerns will need to be addressed before the cost savings and quality improvement benefits of EHR systems can be fully realized.

Regardless of where one stands in this debate, the EHR incentive program's 2014 participation deadline is rapidly approaching, and providers who begin participating in 2013 may be eligible to receive a greater total incentive amount than those who wait until 2014.